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  • Relationship of the disease severity with a main panel of inflammatory and coagulation biomarkers in DVT, cardiovascular disease and stroke
  • Kiana Mohammadian,1 Parisa Alipour,2 Tahereh Kalantari,3,*
    1. Division of hematology and blood banking, Department of Medical Laboratory Sciences, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
    2. Division of hematology and blood banking, Department of Medical Laboratory Sciences, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
    3. Division of hematology and blood banking, Department of Medical Laboratory Sciences, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran\Diagnostic Laboratory Sciences and Technology Research Center, School of Paramedical Sciences, Shiraz University of Medical Science


  • Introduction: Thrombosis is used to describe the abnormal mass forming in the circulatory system from blood components. This condition is known as deep vein thrombosis (DVT) when it takes place in the deep veins. Cardiovascular disease, including coronary artery disease(CAD), cerebrovascular disease, Peripheral artery disease (PAD), and aortic atherosclerosis, is a growing global health concern due to its primary cause of morbidity and mortality. Stroke, a sudden neurological impairment caused by blood flow disruption, is the second most common cause of death worldwide, accounting for 80%-85% of all strokes. Inflammation is the response of cells and substances to harm produced by viral or noninfectious causes. C-reactive protein (CRP), synthesized in the liver, serves as a diagnostic marker for continuous and enduring inflammation. IL-6, a hormone-like cytokine, is crucial in both innate and adaptive immunity, regulating inflammation and stimulating or inhibiting it. Interleukin-1β (IL-1β) belongs to the IL-1 family and is linked to the process of inflammation. TNFα, a proinflammatory molecule, triggers inflammation, increasing plaque vulnerability, with acute phase proteins indicating significant changes in serum levels during inflammation episodes. lactate Dehydrogenase (LDH), a vital enzyme involved in the process of energy metabolism, serves as a biomarker that plays a crucial role in monitoring the prognosis of illnesses. Fibrinogen, a glycoprotein, is categorized as an acute phase protein because it is produced in larger quantities during inflammation. D-dimer indicates increased blood clotting activity and thrombotic events due to its role in fibrin cross-linking. Thrombosis and inflammation are separate physiological processes, although their close association has been recognized in recent years. Tissue factor initiates blood clotting and is produced by blood vessel cells. High levels indicate a negative prognosis in patients with acute coronary syndrome or stroke. In this review, we are examining the correlation between inflammatory and coagulation markers and the occurrence of DVT, stroke, and CVD.
  • Methods: In this review we demonstrated searches with PubMed, Google Scholar, and medical journals identifying articles relevant to our topic.
  • Results: Proinflammatory biomarkers are increasingly being utilized in epidemiologic and intervention research to link systemic inflammation to CVD, stroke, and DVT. High CRP levels can predict future DVT incidence. Elevated CRP levels are associated with atherosclerosis, coronary artery disease, acute stroke, and ischemic stroke. High hs-CRP levels can increase the risk of ischemic stroke and worsen health conditions due to inflammation, complement pathways, and tissue damage. High IL-6 levels lead to inflammation, tissue damage, cardiovascular issues, and increased risk of CVD, and cognitive dysfunction, potentially predicting cerebrovascular illness. Elevated IL-6 levels also increase mortality and stroke outcomes. IL-1β is a key mediator of thrombus formation and local thrombosis, predicting future DVT incidence. It contributes to inflammation, cardiovascular disorders, atherosclerosis, and stroke. TNFα, a key inflammatory cytokine, triggers thrombomodulin production, affecting endothelial cells and phagocytes, leading to edema, vasodilation, and blood coagulation, potentially causing atherosclerosis and stroke. Iron-deficient red blood cells can cause hypercoagulability, thrombosis, cardiovascular diseases, and stroke. Elevated ferritin levels in inflammatory conditions increase CVD risk, and stroke severity is directly correlated with ferritin levels. LDH is a crucial marker for diagnosing infarcts, venous and arterial thrombosis, and malignant tumors. Elevated LDH activity is linked to cardiovascular disorders like myocardial infarction and heart failure, indicating cardiac tissue damage and compromised metabolism. Elevated levels are observed in patients with hemorrhagic infarcts, strokes, and small lacunar infarcts. Fibrinogen is a biomarker that is linked to the development of venous thrombosis in individuals with posttraumatic DVT. Plasma fibrinogen concentration, along with D-dimer or albumin levels, has been linked to the risk of CVD since the 1950s. Fibrinogen, an acute-phase protein, increases post-stroke, increasing the likelihood of subsequent cardiovascular events in stroke survivors. The D-dimer score method classifies individuals into low-, moderate-, and high-risk categories for DVT. A negative D-dimer can rule out DVT. D-dimer is a prognostic indicator for CVD, linked to inflammation and potentially predicting future cardiovascular events. Elevated D-dimer levels can also predict hemorrhagic or thrombotic stroke. TF is linked to cardiovascular disorders, blood clots, and stroke risk, possibly due to atherosclerosis plaques releasing TF.
  • Conclusion: A association exists between inflammatory or coagulation biomarkers including CRP, IL-6, IL-1β, TNF-ɑ, ferritin, fibrinogen, d-dimer, and TF with an unfavorable prognosis in cases of DVT, cardiovascular disorders, and stroke.
  • Keywords: DVT, CVD, Stroke